Quarterly Medicaid Transformation Incentive Report...Quarterly Medicaid Transformation Incentive...

Quarterly Medicaid Transformation Incentive Report

August 2018


(January to June 2018)

The purpose of this report is to detail Delivery System Reform Incentive Payment (DSRIP) program

funding activity related to the Healthier Washington Medicaid Transformation. In accordance with

the Transformation’s Special Terms and Conditions (STCs), DSRIP incentive funds earned by

Accountable Communities of Health (ACHs) are held in accounts managed by an independent

Financial Executor. The Financial Executor distributes these funds to ACHs and their partnering

providers through a web-based portal, called the Financial Executor Portal, under the direction of

ACHs.

This report describes the total amount of incentive funds earned and distributed during the first and

second quarter of 2018 (January – June). ACHs earned a total of $179,379,251, and distributed a

total of $58,852,619 during this time.

Throughout the reporting period, ACHs earned the following types of incentives:

Project Incentives. Earned through successful submission, and full valuation, of ACH

Project Plans. Each ACH earned incentives associated with each of their selected projects.

More information about each project can be found in the Project Toolkit.1

Project Plan Bonus Pool Incentives. Additional project incentives earned by ACHs that

selected more than four projects in their Project Plans.

Integration Incentives. Earned by achieving milestones associated with the transition to

integrated managed care.

In this report, distributed incentives are categorized by Use Categories. ACHs must identify

payments to themselves and partnering providers using standardized Use Categories in the Financial

Executor Portal. Use Categories and associated definitions were developed by the state, with input

from ACHs. More information about Use Categories can be found in the ACH DSRIP Use Categories

fact sheet.2

Please note: Figures in this report are not to be used for ACH-to-ACH comparisons. Each ACH has a

budget and funds flow model specific to its region, approved by the ACH’s decision-making body.

While Use Categories are used by all ACHs to identify the use of funds, each ACH may use them

differently.

For more information, please visit Healthier Washington Medicaid Transformation.3

1 https://www.hca.wa.gov/assets/program/project-toolkit-approved.pdf 2 https://www.hca.wa.gov/assets/use-categories-fact-sheet.pdf 3 https://www.hca.wa.gov/about-hca/healthier-washington/medicaid-transformation

https://www.hca.wa.gov/assets/program/project-toolkit-approved.pdf

https://www.hca.wa.gov/assets/use-categories-fact-sheet.pdf

https://www.hca.wa.gov/about-hca/healthier-washington/medicaid-transformation-resources


August 2018


August 2018

Table A shows the total funds earned and distributed by ACHs through the Financial Executor Portal from January through June, 2018.

Table A. Total funds earned and distributed by ACHs through the portal, January - June 2018.

ACH Total Funds

Earned by ACHs

Total Funds

Distributed by ACHs

Total Funds

Remaining

Better Health Together $15,839,109 $8,867,199 $6,971,911

Cascade Pacific Action Alliance $15,855,032 $6,920,742 $8,934,290

Greater Columbia ACH $24,232,432 $6,869,526 $17,362,906

HealthierHere $37,633,736 $9,011,399 $28,622,337

North Central ACH $10,968,229 $3,830,101 $7,138,128

North Sound ACH $27,872,344 $11,199,986 $16,672,358

Olympic Community of Health $7,215,518 $1,638,436 $5,577,082

Pierce County ACH $21,007,743 $7,647,967 $13,359,776

SWACH $18,755,108 $2,867,263 $15,887,845

Total $179,379,251 $58,852,619 $120,526,633

Table B shows the total funds earned by ACHs through the Financial Executor Portal from January through June, 2018, categorized by incentive type.

Table B. Total funds earned by ACHs by incentive type, January - June 2018.

ACH Project

Incentives Project Plan Bonus Pool

Integration Incentives

Total

Better Health Together $15,839,109 - - $15,839,109

Cascade Pacific Action Alliance

$14,399,190 $1,455,842 - $15,855,032

Greater Columbia ACH $20,158,866 - $4,073,566 $24,232,432

HealthierHere $31,678,219 - $5,955,517 $37,633,736

North Central ACH $7,199,595 $1,455,842 $2,312,792 $10,968,229

North Sound ACH $21,598,786 $1,941,123 $4,332,435 $27,872,344

Olympic Community of Health $5,759,676 $1,455,842 - $7,215,518

Pierce County ACH $17,279,028 - $3,728,715 $21,007,743

SWACH $10,079,434 - $8,675,674 $18,755,108

Total $143,991,903 $6,308,649 $29,078,699 $179,379,251

Medicaid Transformation Quarterly Incentive Report

August 2018

Table C shows the total funds distributed by ACHs through the Financial Executor Portal from January through June, 2018, categorized by Use Category.

Table C. total funds distributed by ACHs by Use Category, January - June 2018. BHT CPAA GCACH HH NC NS OCH PCACH SWACH

Administration $431,500 $176,384 $679,000 - - $1,800,000 - - -

Community Health

Fund - $940,715 - - - $1,800,000 - - -

Health Systems & Community

Capacity Building

$400,000 - - - - - - $307,450 -

Integration

Incentives $1,135,000 - - - $15,000 - - $1,715,209 -

Project

Management - $999,510 $287,000 - $4,666 $3,850 - - -

Provider

Engagement,

Participation & Implementation

$2,395,000 $120,096 $169,000 - $1,762,390 $1,092,000 - $710,000 -

Provider

Performance & Quality Incentives

- - - - - - - - -

Reserve /

Contingency Fund - $587,947 - - - $360,000 - - -

Shared Domain 1 Incentives

$4,505,699 $4,096,090 $5,734,526 $9,011,399 $2,048,045 $6,144,136 $1,638,436 $4,915,308 $2,867,263

Total $8,867,199 $6,920,742 $6,869,526 $9,011,399 $3,830,101 $11,199,986 $1,638,436 $7,647,967 $2,867,263


August 2018

The following tables provide additional detail regarding the funds earned and distributed by each ACH. Better Health Together

Table D. Better Health Together: Total Funds Earned Table E. Better Health Together: Total Funds Distributed

Incentive Type Q1 Q2 Total Use Category Q1 Q2 Total

Project 2A $4,184,238 $3,495,331 $7,679,569 Administration - $431,500 $431,500

Project 2B $2,876,663 $2,403,040 $5,279,703 Community Health Fund - - -

Project 2C - - - Health Systems and Community

Capacity Building - $400,000 $400,000

Project 2D - - - Integration Incentives - $1,135,000 $1,135,000

Project 3A $523,030 $436,916 $959,946 Project Management - - -

Project 3B - - - Provider Engagement, Participation

and Implementation - $2,395,000 $2,395,000

Project 3C - - - Provider Performance & Quality

Incentives - - -

Project 3D $1,046,059 $873,833 $1,919,892 Reserve / Contingency Fund - - -

Project Plan Bonus Pool

- - -

Shared Domain 1 Incentives - $4,505,699 $4,505,699


- - -

Total - $8,867,199 $8,867,199

Total $8,629,990 $7,209,119 $15,839,109


August 2018

Cascade Pacific Action Alliance

Table F. Cascade Pacific Action Alliance: Total Funds Earned Table G. Cascade Pacific Action Alliance: Total Funds Distributed



Project 2B $2,054,760 $1,716,457 $3,771,217 Community Health Fund - $940,715 $940,715

Project 2C $1,214,176 $1,014,270 $2,228,446 Health Systems and Community

Capacity Building - - -

Project 2D - - - Integration Incentives - - -

Project 3A $373,593 $312,083 $685,676 Project Management - $999,510 $999,510

Project 3B $466,991 $390,104 $857,095 Provider Engagement, Participation

and Implementation - $120,096 $120,096


Incentives - - -

Project 3D $747,185 $624,166 $1,371,351 Reserve / Contingency Fund - $587,947 $587,947


$1,455,842 $1,455,842



- - -

Total - $6,920,742 $6,920,742

Total $9,301,288 $6,553,744 $15,855,032


August 2018

Greater Columbia Accountable Community of Health

Table H. Greater Columbia ACH: Total Funds Earned Table I. Greater Columbia ACH: Total Funds Distributed



Project 2B - - - Community Health Fund - - -




Project 3A $770,781 $643,877 $1,414,658 Project Management - $287,000 $287,000




Incentives - - -

Project 3D $1,541,561 $1,287,753 $2,829,314 Reserve / Contingency Fund - - -


- - -



$4,073,566 - $4,073,566

Total - $6,869,526 $6,869,526

Total $15,057,190 $9,175,242 $24,232,432


August 2018

HealthierHere

Table J. HealthierHere: Total Funds Earned Table K. HealthierHere: Total Funds Distributed


Project 2A $9,689,814 $8,094,449 $17,784,263 Administration - - -





Project 3A $1,211,227 $1,011,806 $2,223,033 Project Management - - -


and Implementation - - -


Incentives - - -

Project 3D $2,422,453 $2,023,612 $4,446,065 Reserve / Contingency Fund - - -


- - -



$5,955,517 - $5,955,517

Total - $9,011,399 $9,011,399

Total $23,215,498 $14,418,238 $37,633,736


August 2018

North Central Accountable Community of Health

Table L. North Central ACH: Total Funds Earned Table M. North Central ACH: Total Funds Distributed



Project 2B $938,042 $783,600 $1,721,642 Community Health Fund - - -

Project 2C $554,298 $463,036 $1,017,334 Health Systems and Community


Project 2D $554,298 $463,036 $1,017,334 Integration Incentives - $15,000 $15,000



and Implementation - $1,762,390 $1,762,390


Incentives - - -

Project 3D $341,106 $284,945 $626,051 Reserve / Contingency Fund - - -


$1,455,842 - $1,455,842



$2,312,792 - $2,312,792

Total - $3,830,101 $3,830,101

Total $7,691,357 $3,276,872 $10,968,229


August 2018

North Sound Accountable Community of Health

Table N. North Sound ACH: Total Funds Earned Table O. North Sound ACH: Total Funds Distributed


Project 2A $3,765,814 $3,145,797 $6,911,611 Administration - $1,800,000 $1,800,000

Project 2B $2,588,997 $2,162,736 $4,751,733 Community Health Fund - $1,800,000 $1,800,000



Project 2D $1,529,862 $1,277,980 $2,807,842 Integration Incentives - - -


Project 3B $588,408 $491,531 $1,079,939 Provider Engagement,

Participation and Implementation - $1,092,000 $1,092,000

Project 3C $353,045 $294,919 $647,964 Provider Performance & Quality

Incentives - - -

Project 3D $941,454 $786,449 $1,727,903 Reserve / Contingency Fund - $360,000 $360,000


$1,941,123 - $1,941,123



$4,332,435 - $4,332,435

Total - $11,199,986 $11,199,986

Total $18,041,727 $9,830,617 $27,872,344


August 2018

Olympic Community of Health

Table P. Olympic Community of Health: Total Funds Earned Table Q. Olympic Community of Health: Total Funds Distributed






Project 2D $627,636 $524,300 $1,151,936 Integration Incentives - - -


Project 3B $241,398 $201,654 $443,052 Provider Engagement, Participation

and Implementation - - -

Project 3C $144,839 $120,992 $265,831 Provider Performance & Quality

Incentives - - -

Project 3D $386,237 $322,646 $708,883 Reserve / Contingency Fund - - -


$1,455,842 - $1,455,842



- - -

Total - $1,638,436 $1,638,436

Total $4,594,020 $2,621,498 $7,215,518


August 2018

Pierce County Accountable Community of Health

Table R. Pierce County ACH: Total Funds Earned Table S. Pierce County ACH: Total Funds Distributed





Capacity Building - $307,450 $307,450

Project 2D - - - Integration Incentives - $1,715,209 $1,715,209

Project 3A $570,578 $476,636 $1,047,214 Project Management - - -




Incentives - - -

Project 3D $1,141,156 $953,272 $2,094,428 Reserve / Contingency Fund - - -


- - -



$3,728,715 - $3,728,715

Total - $7,647,967 $7,647,967

Total $13,143,250 $7,864,493 $21,007,743


August 2018

SWACH

Table T. SWACH: Total Funds Earned Table U. SWACH: Total Funds Distributed








Project 3B - - - Provider Engagement,

Participation and Implementation - - -


Incentives - - -

Project 3D $665,674 $556,075 $1,221,749 Reserve / Contingency Fund - - -


- - -



$8,675,674 - $8,675,674

Total - $2,867,263 $2,867,263

Total $14,167,487 $4,587,621 $18,755,108

Quarterly Medicaid Transformation Incentive Report...Quarterly Medicaid Transformation Incentive...

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